Case Study: Adult Deformity
HISTORY
- The patient is a 76-year-old retired attorney who practices recreational tango dancing who presented with severe low back pain and stiffness, left leg numbness and weakness and difficulty walking.
PHYSICAL EXAM
- He had severe weakness of his legs and an obvious curved spine.
PREOPERATIVE IMAGING
AP and lateral X-rays show degenerative spondylolisthesis and scoliosis with left lumbar curve and severe disc collapse from L1 to L5.
PREOPERATIVE IMAGING
Sagittal and coronal MRI sections showing severe arthritis, stenosis, scoliosis and spondylolisthesis
PREOPERATIVE IMAGING
Axial MRI and CT sections showing severe arthritis with hypertrophic facets and stenosis.
DIAGNOSIS
- Degenerative adult scoliosis with severe lumbar spondylolisthesis and lumbar spinal stenosis
SURGERY
- MIS (minimally invasive surgery) L1-L5 XLIF with posterior percutaneous pedicle screws placed from a lateral position between muscle planes.
- 2.5 hours of operative time
- 20 cc blood loss
POSTOPERATIVE IMAGING
AP and lateral X-rays showing multilevel interbody cages placed through a lateral portal and percutaneous screws placed between muscle planes. Note the correction of the scoliotic deformity and restoration of the disc heights.
OUTCOMES
- The patient went home two days after surgery with improved function, decreased weakness, much better posture and significant improvement in his curved spine.
- Five weeks after surgery, he celebrated by taking a trip to Argentina.
- In a patient of these characteristics (elderly with multilevel disease), MIS surgery avoided the large muscle stripping of open back surgery, allowing this patient to recover rapidly with less pain. After this four-level fusion, the patient’s flexibility improved and he was able to touch his toes from a standing position.
Hospital Affiliations
Mt. Sinai
Saint Barnabas Medical Center
Lenox Hill
Formerly St. Luke’s-Roosevelt
Hospital in Manhattan
Livingston, NJ
Formerly Lenox Hill Hospital
in Manhattan
Outpatient Surgery Centers
Malo Surgery Center
201 Route 17 North 12th floor
Rutherford, NJ 07070
Phone: 201-549-8890
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Midtown Surgery Center
305 East 47th St.
New York, NY 10017
Phone: 212-751-2100
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Advanced Spine Surgery Center
855 Lehigh Ave,
Union, NJ 07083
Phone: 908-557-9420
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Denville Surgery Center LLC
3130 Route 10 West
Denville, NJ 07834
Phone: 973-328-3475
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